Provider Demographics
NPI:1811047186
Name:TUBBS-CREWS, SAMANTHA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:
Last Name:TUBBS-CREWS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:REGINA
Other - Last Name:TUBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1408 N WESTSHORE BLVD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-281-8955
Mailing Address - Fax:813-281-2474
Practice Address - Street 1:1408 N WESTSHORE BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-281-8955
Practice Address - Fax:813-281-2474
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health